Relation of the total election isovolume index to symptoms in aortic stenosis

A Doppler-derived total ejection isovolume (TEI) Aftindex has recently been proposed.(1,2) This index combines the evaluation of systolic and diastolic left ventricular (LV) performance and is defined as the sum of isovolumetric contraction time and relaxation time divided by ejection time. The TEI index is easy to obtain by measuring Doppler time intervals from mitral inflow and the LV outflow velocity pattern. It is reproducible, independent of ventricular geometry, heart rate, and blood pressure, and it has shown clinical value in assessing overall cardiac function in various cardiac disorders, such as cardiac amyloidosis, dilated cardiomyopathy, acute myocardial infarction, and primary pulmonary hypertension.(3-7) There is little information, however, about the additional clinical usefulness of a TEI index in patients with aortic stenosis. We measured the conventional systolic function parameter (ejection fraction), the diastolic function parameters (transmitral inflow velocity E/A ratio and deceleration time), and the global function parameter (TEI index) in 191 patients with aortic stenosis and compared them with symptomatic status.